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Kidney donor Ray Fearing, left, meets recipient Erwin Gomez, a 67-year-old cardiovascular surgeon. (Source: Northwestern Memorial Hospital)
From left to right, Erwin Gomez, Dr. Lorenzo Gallon, Ray Fearing and sister Cera Fearing. (Source: Northwestern Memorial Hospital)
(Source: Northwestern Memorial Hospital)CHICAGO (RNN) - For the first time, a kidney has been transplanted twice … and in a span of two weeks.
When the kidney had to be taken out of the original transplant patient, doctors were able to re-transplant it into another patient.
Doctors at Northwestern Memorial Hospital announced the medical breakthrough on Wednesday. The procedures took place in June.
The kidney was donated to Ray Fearing, 27, by his sister, Cera, after he suffered from focal segmental glomerulousclerosis (FSGS). The disease ultimately leads to kidney failure when scar tissue develops on the part of the kidney that filters out waste of the blood.
"We put the kidney in, and it worked immediately, but a couple of days later, we began to see evidence that the disease was coming back aggressively," said Dr. Joseph Leventhal, the transplant surgeon.
"We were crestfallen. We know this can happen, it happens in 50 percent of [FSGS] cases, but you always hope your patient will be successful."
The same disease that caused him to need the transplant in the first place was now attacking the new kidney Fearing had just received only days earlier. Doctors told him it had to be removed.
"When post-surgery tests indicated that Ray was at risk of developing life-threatening conditions due to the reoccurrence of the disease, we had to remove the kidney before he deteriorated," said Dr. Lorenzo Gallon, medical director of the kidney transplant program at Northwestern Memorial Hospital.
Lorenzo, Leventhal and other experts at Northwestern Medicine evaluated the case to determine if the kidney could be re-implanted into another patient.
After weighing the risks, including the possibility that the kidney would not recover from minor damage it incurred while being exposed to FSGS, the medical team felt confident enough to move forward.
"Our sense was this was due to something in the circulation the bloodstream of the first transplant recipient. When we saw the kidney was slowly being destroyed, but on biopsy the kidney looked like it could work for someone else, that's when we hatched the idea," Leventhal said.
The kidney originally meant for Fearing would become someone else's lifeline.
"We said ‘We could discard it or we think we could transplant it into someone else.' His response was ‘Lets do it.' He was fully supportive of the idea," Leventhal said.
"Over the next several days, we put together the necessary team to make it all happen."
Two weeks after receiving what he hoped would be his miracle, Fearing became someone else's miracle, donating the kidney to Erwin Gomez, a father of five from Indiana, who suffered from hypertension.
"[Dr. Gallon] was frank and honest about it. He explained the theory behind it and [said] if I was willing to go through with it, it could be done," Gomez said. "That was very assuring. This was a chance for me to get a kidney much earlier than what could be expected."
Gomez had been on the donor list for about four months.
The kidney regained function almost immediately after the transplant. A little more than a week later, tests showed a reversal of the damaged caused by the FSGS in Fearing's body.
Gomez underwent his procedure at the end of June 2011 and says he "feels great" now.
"My strength is back to where it was before, my energy level is good and I'm thinking of returning to work," said the 67-year-old cardiovascular surgeon.
"I'm back on track. It was a long detour but right now, I'm really back to where I was. I'm just happy that I may be able to return to what I was doing before and hopefully be of more service to people. "
Leventhal calls the procedure "a ground-breaking moment" because it shows that a kidney can recover after being exposed to FSGS after being transplanted.
"This proves that when an organ fails in one body, it may thrive in another," he said.
Meanwhile, Fearing still needs a kidney. He's back on dialysis while he waits and hopes for the day another possible match is available.
"It may not have been my time, but I am grateful that I was able to help another patient," said Fearing. "My day will come."
Kidneys can be donated from both the living and deceased.
Statistics show living donor transplants last almost twice as long as deceased donor transplants. Leventhal says a kidney from a living donor can last 15-20 years as long as patients are vigilant about taking their anti-rejection medication.
The greatest risk of rejection is in the first year after transplantation.
"Rejection, which used to be a commonplace event 20 to 30 years ago, is quite uncommon now. It only occurs in only 1 and 10 cases," he said.
"People tend to view rejection as very binary. It's rejected and that's it. But it's a rejection attempt, a rejection episode. This is usually very easily identified when it occurs and it's usually very easily treated.
More than nine out of 10 patients who have a rejection episode, it can be reversed."
According to the National Kidney Registry, living donors are given priority on the deceased donor list should they ever need a kidney later on.
For more information about becoming a kidney donor, visit www.kidneyregistry.org.
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